Purpose or Case Report: Pediatric carotid artery Intima-Media Thickness (IMT) is a non-invasive ultrasound marker of early atherosclerosis. Obesity in children is associated with increased IMT. The objective of this meta-analysis is to report IMT values in children living with overweight/obesity in the literature.
Methods & Materials: This review was conducted according to PRISMA guidelines, including only cohorts with normal controls. Included criteria were IMT measured using B-mode or radiofrequency (RF) techniques and based on the four officials' consensus: American Heart Association, the Association for European Pediatric Cardiology (AEPC), the Mannheim Consensus and the American Society of Echocardiography recommendations. For the definition of overweight and obese children, we used Body mass index (BMI) > one standard deviation above the WHO growth standard median or BMI > 85th. Relevant articles were extracted from PubMed, Cochrane Library, Embase and Web of Science with the support of a medical librarian (FB). They were searched from inception to July 2021. We used the following keywords: “Carotid Intima-Media Thickness” AND “Child” OR “Adolescent” OR Adolesc* OR teen*. A meta-analysis was performed by a biostatistician (SG) using the R software version 4.0.2. A significance level of 5% was adopted.
Results: We obtained 13 B-mode-based and two RF echo-tracking-based IMT measurement studies. IMT is significantly increased in children living with overweight/obesity. The mean IMT difference in this meta-analysis was 0.042 mm, 95% confidence interval [CI] 0.054-0.030, using the B-mode technique, and 0.045 mm, 95% [CI] 0.062-0.030 using the RF technique. The IMT value in normal children was 0.44 mm [CI] 0.41-0.46 versus 0.48 mm [CI] 0.45-0.51 for overweight/obese using B-mode and 0.36 mm [CI] 0.28-0.44 versus 0.41. mm [CI] 0.31-0.51 using the RF technique.
Conclusions: Based on this meta-analysis, we can conclude that IMT is significantly increased in overweight/obese than in healthy children according to both techniques.